HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Housing Services; 2008-04-28RECORDS DESTRUCTION REQUEST
City Clerk/Records Management
Page 1 of 2
Department Requesting Destruction:o
,- --- pApprovals for Destruction'
Department Head Date
.ecords Manager Date
-vl-o*
Attorney Date
We certify that the records listed below have been retained for the scheduled retention period, required audits have
been completed, and no pending or ongoing litigation or investigation involving these records is known to exist.
Person(s) Completing Form: , «-^f "\
Po-VVi Cresc^crVx W_3^
No.
1
2
RECORDS DESCRIPTION
Operating and Capital BudgeT (File 1 , 2, 3 and 4);
H&R Open PO's 2004-2005: AcctsuPyble 2004-
2005 (_£j -B^Ji/^fuJL <?J^~r~*fo€>)
H&R Timecards 2004-2005; H&R Data 2004-
2005 (File 1&2); CDBG Data File 1&2 2004-2005;
Accts Pyble 2005-2006; H&R Data 2005-2006 (File
1&2); CDBG Data (File 1&2) 2005-2006
(&]^^Ji ^~ (jO>
DATED
2004-
2005
2005-
2006
BOX
No.
150
151
RRS No.
0550-05
0550-05
RRS
Period
C(HZ.
CO+Z-
BARCODE APPROVED By
City Attorney
H=HOLD
RECORD DESTRUCTION COMPLETED BY :_
CERTIFICATE OF DESTRUCTION? Yes O No [j
SMEADLINK BARCODES DELETED BY:A/a
DATE : C*-\f &$/d&cfc
DATE:
This form documents the destruction of City records in accordance with the California Public Records Act
Revised 08/25/2005
CERTIFICATE OF DESTRUCTION
DOCUMENT MANAGEMENT
CITY OF CARLSBAD
2351 FARADAY AVE
CARLSBAD, CA 920087217
CONTACT: Tanya Bjork - Phone: (760)602-2786
SERVICE PERFORMED
Pounds
Minutes ^,
*• 3
SVC'D ADD'L
SERVICE TICKET #:
DATE:
CUSTOMER #:
SERVICE/TYPE:
NEXT SERVICE DATE:
NEXT SERVICE TYPE:
Lock(s) Present/Operable:
Clasp(s) Present/Operable:
OOG36 - 42136
04/28/2008
10284
Purge/Onsite
Not scheduled.
Not scheduled.
Yes
Yes
No
No
COMMENTS: I ^ I I
This certificate is to certify that Cintas Document Management will shred confidential data per customer's instructions and according to HIPAA & GLBA
regulations for the above-mentioned company. Mobile destruction services are NAID certified. Non-paper destruction services are not NAID certified.
CUSTOMER SIGNATURE:
SERVICE REP SIGNATURE:
9455 WAPLES ST • STE. 110 • SAN DIEGO, CA 921213924 • Phone: (858)678-0460 • Fax: (858)678-0894